Describes toothache. Lists symptoms and possible causes. Also describes gum disease, including gingivitis and periodontal disease. Includes interactive tool to help you decide when to call a doctor. Offers prevention tips.
Toothache and Gum Problems
Toothaches and gum problems
are common but usually can be prevented by taking good care of your teeth and
gums. Keeping your
gums, and the bones around your teeth healthy requires regular brushing, flossing,
and good nutrition. Brush your teeth twice a day with an American Dental Association (ADA) accepted fluoride
toothpaste. Clean between teeth daily with floss or an interdental cleaner. For
more information on proper brushing and flossing techniques, see the topic
Basic Dental Care.
Sometimes you may have tooth pain when
you touch a tooth or when you eat or drink foods that are hot, cold, sweet, or
sour (a sensitive tooth). Mild sensitivity can be caused by shrunken (receded)
gums or a worn-down tooth. Moderate to severe sensitivity can mean a tooth has
cracked, a dental
cavity is present, or a
filling has been lost. Seeing a
dentist for treatment can prevent the tooth from
The most common cause of a toothache is
tooth decay, although a toothache may not be present in the early stages of
decay. Other reasons for a toothache might include:
An infection of or around the tooth (abscess). A red, swollen,
painful bump may be found near or on the side of the sore tooth. The tooth may
especially hurt when you bite down.
A tooth that has not broken
through the gum (impacted tooth). Gums may be red,
swollen, and sore. The area around this tooth can ache, throb, and be quite
Problems with or injury to the nerves in the center of
the tooth (pulp), which can be caused by an injury to the face or from grinding
or gnashing the teeth.
Sometimes a toothache can be caused by another health
problem, such as:
Alcohol or drug
abuse, especially methamphetamines.
Vitamin deficiencies, such as
too little vitamin B12.
are pink and firm and do not bleed easily. Occasionally your gums may bleed if
you brush your teeth and gums too hard, use a hard-bristled toothbrush, or snap
dental floss hard against your gums. Be gentle with your teeth—use a
soft-bristled toothbrush and floss carefully to help prevent bleeding gums.
Gingivitis is a gum disease that causes red,
swollen gums that bleed easily when brushed. Because gingivitis usually doesn't
cause pain, many people delay treatment. If not treated, gum disease can cause
more serious problems with the gum tissue.
Periodontitis is severe gum disease and is caused by long-term
infection of the gums, bone, and other tissues that surround and support the
teeth. It can progress until the bones that support the teeth are damaged. In
this late stage, teeth may become loose and fall out or need to be removed.
Early treatment of gum disease is important to prevent tooth loss.
Other causes of gum bleeding, swelling, and pain include:
Pregnancy, blood-thinning medicines, or bleeding
disorders. Each of these can cause gums to bleed easily.
vitamins, such as vitamin K or vitamin C, or medical
problems, such as
anemia, that interfere with the body's ability to
absorb certain vitamins.
babies and young children. For more information, see the topic
Medicines such as Dilantin or
calcium channel blockers.
Dentures or a dental appliance that
irritates the gums.
An infection around the root of the tooth.
Swelling and redness, sometimes with pus, may appear at the base of a
Smoking and using other tobacco products increases your risk
for gum disease. Smokers have a higher chance of having gum disease throughout
their mouths than nonsmokers. You may not have symptoms of bleeding or swollen
gums because the normal bleeding immune response is affected by tobacco use.
Chewing tobacco or using snuff may push the gums back in the area of the mouth
where the tobacco is inserted. Constant irritation caused by tobacco products
increases your risk of
Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:
Your age. Babies and older
adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Call your dentist now to discuss the symptoms and
arrange for care.
If you cannot reach your dentist or you don't
have one, seek care in the next hour.
Many prescription and nonprescription medicines can cause
mouth problems. A few examples are:
Medicines used to treat cancer
Medicines used after
Call 911 Now
Based on your answers, you need
Call911or other emergency services now.
After you call
911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are:
Diseases such as diabetes, cancer, heart disease,
Long-term alcohol and drug
Steroid medicines, which may be used to treat a variety
Chemotherapy and radiation therapy for
Other medicines used to treat autoimmune
Medicines taken after organ transplant.
having a spleen.
Pain in adults and older children
Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Symptoms of a heart attack may
Chest pain or pressure, or a strange feeling in the chest.
Nausea or vomiting.
Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.
Lightheadedness or sudden
A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness,
tingling, or a strange feeling in your chest or other areas.
Mouth and Dental Injuries
To reduce pain and swelling of a
toothache, use an
ice pack on the outside of your cheek; do not use heat. Avoid very hot,
cold, or sweet foods and drinks if they increase your pain.
To reduce sensitivity to heat,
cold, or brushing, consider using a toothpaste specifically designed for
sensitive teeth. Brush with it regularly or rub a small amount of the paste on
the sensitive area with your finger 2 or 3 times a day. Floss gently between
Medicine you can buy without a prescription
Try a nonprescription
medicine to help treat your fever or pain:
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.
Be sure to follow these
safety tips when you use a nonprescription medicine:
Carefully read and follow all directions
on the medicine bottle and box.
you have been told to avoid a medicine, call your doctor before you take
If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
If your gums
are mildly swollen and red, use a tartar-control toothpaste that contains
fluoride and an antiseptic mouthwash, such as Listerine, or a mouthwash that
contains fluoride. Make sure you brush after meals and snacks and floss every
day. If you cannot brush after eating, chew sugar-free gum, use a tooth pick,
or rinse your mouth with
warm salt water. You can make your own salt water by
mixing 1 tsp (5 g) of salt in a medium-sized glass [8 fl oz (240 mL)] of warm water.
Tobacco can cause many gum problems, decreases your
ability to fight infection of your gums, and delays healing. Do not smoke or
use other tobacco products. For more information, see the topic
Do not use illegal
drugs, such as methamphetamines, which cause tooth and gum problems.
Avoid foods that contain a lot of sugar. Sugar helps
Ask your dentist or dental
hygienist about tongue cleaning. You can use a tongue cleaner or a
soft-bristled toothbrush, stroking in a front-to-back direction. Tongue
cleaning is particularly important for people who smoke or whose tongues are
coated or deeply grooved.
Ask your dentist or hygienist whether he
or she recommends using a mouthwash that contains fluoride and ingredients to
Schedule regular trips to the dentist. Most dentists
recommend exams and cleaning 2 times a year. Some experts believe those who are
at low risk for dental problems need only a yearly exam.
regular checkups or recommended blood tests ordered by your doctor
if you are on a blood-thinning medicine or you have a bleeding
Do not smoke or use other tobacco products because it
decreases your ability to fight gum infection and delays healing. For more
information, see the topic
Do not use illegal
drugs, such as methamphetamines, which cause tooth and gum problems.
How this information was developed to help you make better health decisions.